Provider Demographics
NPI:1043950280
Name:HUNT, RENATTA ELIZABETH FASCHING (CMT)
Entity type:Individual
Prefix:MRS
First Name:RENATTA
Middle Name:ELIZABETH FASCHING
Last Name:HUNT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:MS
Other - First Name:RENATTA
Other - Middle Name:ELIZABETH
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:4219 LILAC DR N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1217
Mailing Address - Country:US
Mailing Address - Phone:612-284-7333
Mailing Address - Fax:
Practice Address - Street 1:1224 2ND ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1130
Practice Address - Country:US
Practice Address - Phone:612-339-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty